Family Physicians Cite Two Flaws in Legislation

LEAWOOD, Kan. — Although the 21st Century Cures bill would implement policies to hasten treatment of illnesses, it fails to provide mandatory funding for the programs designed to address prevention and treatment of opioid abuse and addiction—America’s greatest health crisis. Moreover, by draining money from the Prevention and Public Health Fund, the bill helps perpetuate a health system that focuses on treating sickness rather than preventing disease.

Those were the comments sent in a letter to the U.S. House leadership by Wanda Filer, MD, MBA, board chair of the American Academy of Family Physicians.

“The AAFP recognizes fully that the core policies advanced by this legislation are aimed at identifying and accelerating the availability of treatments and interventions aimed at cancer and other terminal illnesses,” Filer wrote. “We certainly applaud your commitment to this effort and support your intentions wholly. However, we do urge you to reconsider the two issues we outlined in this letter.”

Noting the legislation included numerous policies that are important to AAFP members and their patients, “there are two areas which we must express significant disappointment,” Filer said in the letter. “First, the legislation fails to allocate mandatory funding to address the nation’s rapidly escalating opioid crisis. Second, the legislation takes money dedicated for the prevention of disease to finance the treatment of disease.”

Opioid addiction has become an escalating national health crisis. The rate of overdose deaths involving prescription pain medications and heroin nearly quadrupled since 1999. According to the most recent data, nearly 19,000 people died from prescription pain medication overdoses and more than 10,500 people died from heroin overdoses in 2014.

“Despite growing mortality rates that are shattering families and communities, this legislation fails to allocate mandatory funding to address our nation’s alarming opioid crisis,” Filer wrote. “Furthermore, the legislation stops well short of appropriately funding the important mental health and addiction provisions that are included. While we applaud the attention paid to the opioid crisis and addiction more broadly, we are deeply disappointed that definitive and decisive action is not being taken to expressly allocate funding to combatting the current crisis and preventing the next one. Each day that treatment and prevention programs go unfunded is a day that more Americans die as a result of this epidemic. We urge you to reconsider the inclusion of mandatory funding for this devastating crisis.”

Equally disappointing is the bill’s rescission of $3 billion in the Prevention and Public Health Fund to pay for research into diseases that could be prevented or better managed through primary care. Noting that chronic diseases are the leading cause of death in the United States, Filer said many could be prevented or better managed through primary and preventive care in early stages of illness.

“We remain confused and strongly concerned that Congress continues to provide billions toward research into treatment while depleting resources aimed at preventing disease through primary care and preventive services,” Filer wrote. “At some point in the near future, funding for disease prevention should receive equitable consideration to that of the margins of companies which produce treatment interventions for those same diseases.”

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Founded in 1947, the AAFP represents 124,900 physicians and medical students nationwide. It is the only medical society devoted solely to primary care.

Family physicians conduct approximately one in five office visits -- that’s 192 million visits annually or 48 percent more than the next most visited medical specialty. Today, family physicians provide more care for America’s underserved and rural populations than any other medical specialty. Family medicine’s cornerstone is an ongoing, personal patient-physician relationship focused on integrated care.